Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.64 / $85.64 / $170.78	Facility	26	$85.64	$85.64	$170.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $334.98 / $475.00 / $759.85	Professional		$334.98	$475.00	$759.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.51 / $118.59 / $571.35	Professional	26	$70.51	$118.59	$571.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $264.47 / $335.00 / $462.42	Professional	TC	$264.47	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $247.59 / $247.59 / $322.85	Professional		$247.59	$247.59	$322.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.30 / $65.37 / $117.01	Professional	26	$52.30	$65.37	$117.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $243.30 / $328.93 / $328.93	Professional	TC	$243.30	$328.93	$328.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $301.83 / $612.00 / $1,183.98	Professional		$301.83	$612.00	$1,183.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.37 / $118.00 / $156.88	Professional	26	$65.37	$118.00	$156.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.95 / $494.00 / $878.69	Professional	TC	$234.95	$494.00	$878.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.31 / $843.54 / $1,488.57	Professional		$400.31	$843.54	$1,488.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.31 / $106.57 / $181.69	Professional	26	$76.31	$106.57	$181.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $319.86 / $668.58 / $1,316.48	Professional	TC	$319.86	$668.58	$1,316.48
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $127.43 / $151.00 / $250.52	Facility	26	$127.43	$151.00	$250.52
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,232.73	Professional		$300.42	$300.42	$1,232.73
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $973.25 / $973.25 / $973.25	Professional	TC	$973.25	$973.25	$973.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $252.59 / $399.08	Professional		$63.54	$252.59	$399.08
United Facility/Professional Professional Modifier Low / Median / High Price $360.22 / $609.97 / $1,359.17	Professional		$360.22	$609.97	$1,359.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.22 / $96.35 / $154.19	Professional	26	$73.22	$96.35	$154.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $286.27 / $475.72 / $1,227.99	Professional	TC	$286.27	$475.72	$1,227.99